Metabolic signature of EAT-Lancet diet in relation to risk of frailty: a prospective cohort study

The EAT-Lancet Commission proposed a planetary health diet in 2019, yet its association with frailty remains unclear. This study aimed to examine the relationships between adherence to the EAT-Lancet diet, metabolomic profiles, and frailty risk among older adults. We included 44,465 participants from the UK Biobank, with a mean age of 55.88 years. Frailty was defined based on five physical criteria. Elastic net regression identified a 20-metabolite signature associated with the EAT-Lancet diet. Cox models showed that higher diet adherence was significantly associated with reduced frailty risk (HR: 0.51, 95% CI: 0.40 to 0.64). Each standard deviation increase in the metabolic signature was also associated with lower frailty risk (HR: 0.69, 95% CI: 0.63 to 0.75). Mediation analysis indicated that metabolites mediated 9.88% of the diet-frailty association. These findings suggest that greater adherence to the EAT-Lancet diet may lower frailty risk, partly mediated through specific metabolic pathways.